“I am losing my hair,” “my hair is thinning,” “my hairdresser told me that I’m losing my hair” are statements that elicit a common reaction among dermatologists, such as “will I find out what the patient has?,” “will I need to do a biopsy,” “will I have to do hormonal and systemic evaluation,” “will I be able to help the patient?,” and “will the patient have one disorder or more?”.
History is extremely helpful and can place the patient in one of two categories of hair loss: increased hair shedding (diffuse AA and TE) and progressive hair thinning (androgenetic alopecia). Further questioning includes hormonal status, list of medications, history of recent febrile illness, surgery, and other traumatic experiences, family history of scalp hair thinning, detailed medical history, and hair styling techniques.
History and examination lead to a diagnosis in the majority of cases. Histological examination is of moderate value.